State limits non-urgent ER vists to save $34M

Hospitals have been trying different tactics to reduce emergency room (ER) visits. Now, state governments are getting in on the act by restricting the number of government-insured patients who can visit the ER.

Beginning Oct. 1, the state of Washington will limit non-emergency ER visits by Medicaid recipients, reports KPLU. Only three non-emergency trips to the ER will be covered by Medicaid each year, in an attempt to cut back on unnecessary ER-related costs. Hospitals will be allowed to bill patients for any services provided over the limit.

"Non-emergency issues and chronic conditions should be treated by a primary care provider, not by an expensive visit to hospital emergency rooms," Washington Health Care Authority Director Doug Porter told KPLU.

By placing a cap on non-urgent ER visits, lawmakers project savings of $34 million a year. That's more than one-third of the $98 million the state spent on hospital ER visits last year, notes KPLU.

Meanwhile, emergency departments in Wisconsin are reducing non-urgent visits by coordinating care and utilizing health information technology tools, Joy Tapper, executive director of the Milwaukee Health Care Partnership, wrote in a recent Hospital Impact blog post.

Emergency departments in Milwaukee County--at which about 48 percent of all visits are non-urgent--agree with the Washington Health Care Authority's position on redirecting patients with non-emergency issues to primary care providers. "Moreover, our goal is to connect these high-risk patients with primary care physicians in medical homes, a setting most appropriate for their health needs," Tapper wrote.

For more information:
- read the KPLU article
- check out the blog post

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